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Elected leaders, mental health providers and members of the public turned out Tuesday night to share their visions of a robust mental health care system. It was part of a systematic review of services for people living with mental illness.

More than 70 people gathered in the Multnomah County boardroom to screen the documentary Not Broken, featuring youth who have lived with mental illness, including depression, anorexia, and bipolar disorder, before splitting off into small groups to share their own stories, frustrations and hopes.

“There’s tremendous power in coming together to share our collective stories, and as support to one another,” said Chris Bouneff, executive director of the Oregon chapter of the National Alliance on Mental Illness (NAMI). “Whenever I come to these, it’s a good reminder that you’re not alone.”

He said he had hesitated when staff from Commissioner Sharon Meieran’s office invited him to facilitate the event. “Really, another listening session?” he thought. “In 10 years, I’ve been to about 10 million of these.”

But Meieran is offering more than just a friendly ear.

As an emergency department doctor at Kaiser, she said too often she sees patients come in mental health crisis to a setting ill-equipped to treat them.

“We weren’t able to catch people before they came to see us, and often once they get to the ER, there was nowhere for people to go,” she said. “Too often people end up in crisis, in jails, in the street.”

Meieran said she ran for office, in part, to improve the mental health care system. To start the work, she secured $60,000 from the county General Fund to map the mental health care system and recommend changes. Human Services Research Institute began the work on the mapping project this fall and plans to present findings to the Board of County Commissioners this spring. Researchers are interviewing experts, pulling data and have held two listening sessions and small group interviews with service providers and the public.

The evaluation includes an examination of funding sources and gaps in services — the primary safety-net provider being the county’s own Mental Health and Addiction Services Division. With a staff of more than 200 and a budget of nearly $100 million, the Division offers long-term and crisis mental health services in partnership with nonprofit providers to low-income households, people who don’t have insurance and residents enrolled in the Oregon Health Plan.

Tuesday night’s event is the second Meieran’s office has hosted, asking what works, and what doesn’t, in Multnomah County’s mental health system.

Student Emma Cooper said she would like to see more mental health services located in schools. But she said she would also like youth to have access to counselors who are not mandatory reporters. Student Health Center staff, like school staff, are required to report suspicions of abuse and neglect. Cooper said youth may not be ready to take formal action if they are experiencing abuse, but may still want to seek counsel.

Nearby, resident Karen Henell’s group expressed frustration at a culture that treats mental illness as a chronic condition. They would like to see a system that emphasizes,“this is something people can recover from,” she said, “instead of, ‘it’s always going to be like this.’”

Small groups talk about their vision for a well-functioning mental health system.

Christina Healy, an American Sign interpreter, said she wanted to see resources for people who are hearing impaired and people who speak languages other than English.

Charlene Turenne, a former high school teacher and emergency department nurse, had joined students from the Multnomah Youth Commission and Meieran’s own daughter in a small group to talk about mental health and youth.

She wants mental illness to be treated like any other cognitive disorder, she said. “We have compassion for some brain disorders like Alzheimer's,” she said. “You know, we don’t take grandpa off to jail.”

She said it seems that public figures will admit and speak openly about socially acceptable mental illnesses such as depression or anorexia. But rarely does someone famous admit to having, or loving someone who has bipolar disorder and paranoid schizophrenia.

“It’s so hidden,” she said.

Her son was diagnosed with paranoid schizophrenia in his late 20s, six years after first showing symptoms. The chaos has continued into his 30s. “He would act out,” she said. “The police would come, and take him to the ER. He would be held in a psych unit for a few days, and I couldn’t see him because he was over 18. Then someone would call me to pick him up.”

Back at home he would refuse to take medications. And the cycle repeated itself.

“It’s a revolving door. It’s Band-Aids,” she said. “It’s always been a Band-Aid, and then goodbye.”